This is the first book in a series inspired by the WOOSP (World Congress on Ovulation Induction & Ovarian Stimulation Protocols) Conferences, which were a bi-annual event in India hosted by the IVF Lite Foundation. This volume is based on the updated lectures from WOOSP 2015, held in Seychelles in September 2015.
Ovarian stimulation protocols are currently chosen mainly on the basis of personal preferences and individual experience rather than objective evidence based medicine, and in poor responders, as well as in polycystic ovary syndrome (PCOS) patients undergoing assisted reproductive techniques (ART), they constitute a significant challenge for clinicians, even today. Several protocols have been proposed that, when properly utilized, should improve pregnancy rates while keeping potential complications to a minimum. This book defines better predictors of ovarian response to stimulation and allow stimulation protocols to be tailored to individual patients. As such,it is a must-have textbook for clinicians wanting to sharpen their skills and keep abreast of developments in the field.
Part I: Physiology.- The Physiology of Ovulation - Current Concepts.-
The Physiology of Controlled Ovarian Stimulation: Contemporary
Understanding.- Physiology of Mild Stimulation : Current Concepts.- Part II:
All About IUI.- Single Versus Double Inseminations in IUI - Scientific
Rationale and Results.- Do We Get Acceptable PRs Using GnRHa as Trigger in
IUI cycles?.- Stimulation Protocols for IUI.- Clomiphene Citrate Versus
Aromatase Inhibitors in IUI Cycles.- Effect of GnRH Antagonists on Clinical
Pregnancy Rates in Ovulation Induction Protocols With Gonadotropins and IUI
Therapy.- Part III: Agonist Cycles.- In Vitro Fertilization Using Pituitary
Down-regulation with Depot GnRHa.- The Serum Level of C-Reactive Protein in
Patients Undergoing GnRH Agonist Protocols for In Vitro Fertilization
Cycles.- Part IV: Antagonist Cycles.- Tackling Follicular Asynchrony in GnRH
Antagonist Cycles.- Newer Antagonist Protocols.- Part V: Role of LH.-
Efficiency and Efficacy of Exogenous Gonadotropins Containing LH Activity.-
Luteinizing Hormone Add-back: Is it Needed in Controlled Ovarian Stimulation?
If Yes, When?.- Part VI: Triggering Ovulation in ART.- GnRH Trigger to
Prevent OHSS.- GNRHa Trigger: Why, When, How?.- Dual Triggering with GNRHa &
hCG.- Luteal Phase Support After Gonadotropin Releasing Hormone Agonist
Triggering in Fresh Embryo Transfer.- Part VII: Poor Responders.- Minimal
Stimulation in Poor Responders.- Recombinant LH in Diminished Ovarian Reserve
(DOR).- Does the Addition of Clomiphene Citrate or Letrozole to Gonadotropin
Treatment Enhance the Oocyte Yield in Poor Responders Undergoing IVF?.-
Concurrent Dual Stimulation for Poor Responders.- IVF Lite With PGT-A is the
Way Forward in 2019.- Microdose Flare-up vs. Flexible-multidose GnRH
Antagonist Protocols for Poor Responder Patients.- LH Pretreatment as a Novel
Strategy for Poor Responders.- Part VIII: Hyper-responders.- PCOS and
Antagonist Protocol.- Agonist and Antagonist Coast.- First Intention IVF
Protocol for Polycystic Ovaries: Does Oral Contraceptive Pill Pretreatment
Influence COH Outcome?.- Comparison of Albumin and Cabergoline in the
Prevention of Ovarian Hyperstimulation Syndrome.- Outcome of Ovarian Drilling
in Women with Polycystic Ovary Syndrome.- Comparison Between Unilateral and
Bilateral Ovarian Drilling in Clomiphene Citrate Resistance Polycystic Ovary
Syndrome Patients.- Ovulation Induction in Obese PCOS Patients.- Part IX:
Luteal Phase Support.- Newer Friendly Subcutaneous Progesterone.- Should
Intramuscular Progesterone Still be Used in ART?.- Part X: Ultrasound.- One
Step Ultrasound Assessment of the Infertile Woman.- Comparison of Ovarian
volume and Antral Follicle Count with Endocrine Tests for Prediction of
Responsiveness in Ovulation Induction Protocols.- Fluid in the Endometrial
Cavity Does it Really Matter for Implantation Success?.- Part XI:
Endometriosis.- Effect of Endometrioma and Its Excision on Ovarian Reserve.-
Management of Endometrioma in Reproductive Aged Women: Balancing Harm and
Benefit.- Ovarian Response in IVF after Laparoscopic Ovarian Cystectomy.-
Comparison of Ovulation Induction Protocols after Endometrioma Resection.-
Part XII: Vitrification.- Then and Now - Evolution of Vitrification
Techniques in 30 years.- Oocyte Vitrification and Cancer Patients.- Practical
Clinical Aspects of Oocyte Vitrification for Elective Fertility
Preservation.- Embryo Vitrification Program: Technique, Device or Embryo
Quality - What Matters?.- Frozen Embryo Transfer Protocol: Does Spontaneous
Cycle Give Good Result?.- Outcome of Vitrified-Thawed Embryo Transfer in the
GnRH Agonist Versus Antagonist Protocols.- Part XIII: PGD/PGS.- Stimulation
Strategies Before PGD/PGS.- The Current Status of Preimplantation Genetic
Screening.- PGD for Couples at Chromosomal Risk.- Part XIV: Controversies.-
Stimulation Strategies Before Preimplantation Genetic Testing.- Evidence
Based Management of unexplained Infertility.- Role of Antibiotics Prior to
Embryo Transfer.- Role of GCSF in ART Cycles.- Strategies to Improve
Endometrial Thickness.- Is There Still A Role for Injury to the Endometrium
Before IVF.- Estrogen Priming Resource or Gimmick?.- The Contribution of
Sildenafil (Viagra) to Ovarian Stimulation With Gonadotropins.- Should ART
Cycles be Primed with OCP or Progesterone.- Does Endometrial Thickness Have
Any Role in Replacement Cycle Success Rate?.- Role of Oral Fertility Drugs
in Unexplained Infertility.- What Not to Do in Infertility Practice.- Part
XV: IVM.- IVM vs. IVF with a Gonadotropin-Releasing Hormone Antagonist for
Women With Polycystic Ovarian Syndrome: Can Superiority be Defined?.-
Estrogen Suppressed In Vitro Maturation: A Novel Approach to IVM.- Part XVI:
Stimulation & Malignancy.- Is There An Ideal Stimulation Protocol for Cancer
Patients?.- Part XVII: The IVF Lab.- Time-lapse in the IVF-lab: How Should We
Assess Potential Benefit?.- Importance of Cytoplasmic Granularity of Human
Oocytes in In-Vitro Fertilization Treatments.- Part XVIII: Natural Cycle &
Minimal Stimulation Protocols.- Modified Natural Cycle in In-Vitro
Fertilization.- Impact of Minimal Stimulation Protocols on the Developing
Embryo.- Part XIX: Progress.- Tailor-made Ovarian Stimulation- The Future of
IVF.- Newer Advances in Fertility Treatment.
Dr Gautam Nand Allahbadia is Consultant Reproductive Endocrinology & IVF at the Millennium Medical Center MMC IVF, DHCC; Canadian Specialist Hospital, Dubai; and Bourn Hall Fertility Clinic, Jumeira, Dubai, UAE. He is the founder and academic mentor of Rotunda - The Center for Human Reproduction, the world-renowned fertility clinic in Mumbai. He is a noted world authority on Ultrasound-guided Embryo transfers and one of the pioneers in Third Party Reproduction in Southeast Asia. Dr. Allahbadia was responsible for Indias first trans-ethnic surrogate pregnancy involving a Chinese couples baby delivered by an unrelated Indian surrogate mother. Gautam N Allahbadia is the Emeritus Editor of the Journal of Obstetrics & Gynecology of India as well as the IVF Lite (Journal of Minimal Stimulation IVF).He cherishes over 150 peer-reviewed publications, 142 book chapters and 31 textbooks, the latest being a comprehensive two book set textbook published by Springer Nature, entitled 'Textbook of Assisted Reproduction' , and is on the Editorial Board of several International Journals. Dr. Allahbadia was elected as the Vice President of the World Association of Reproductive Medicine (WARM), headquartered in Rome, and Mumbais Top Doc for 2012 by a peer nomination process.
Goral Gandhi is a Clinical Embryologist with over 25 years of experience in the field of IVF and assisted reproductive techniques (ART). She is the founder and Scientific Director of Indo Nippon IVF as well as the International School for Reproductive Medicine and Embryology (ISRME) in Mumbai, India. She has an extensive experience in designing and maintaining successful IVF laboratories as well as in IVF education. An expert on all aspects of embryology and laboratory management, she has trained more than 600 embryologists and clinicians from over 19 countries. Throughout her career, Goral has been actively involved in clinical embryology research toward improving pregnancy outcomes. The last ten years of her career have been dedicated to optimizing cryopreservation protocols. She has contributed numerous papers and chapters in both national and international journals and textbooks. She is regarded as a key opinion leader in the field of fertility preservation around the globe, and is the co-editor of the textbook "Vitrification in Assisted Reproduction - A Users Manual," published by Springer International.
